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NPI Code Detail

MEDICARE: REBECCA WARD

MEDICARE:   REBECCA  WARD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225700000XMassage TherapistMT005304GA

General Provider Information

NPI Number : 1710330162
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA WARD
Provider Business Mailing Address
First Line : 176 ATLANTA ST
Second Line : SUITE B
City : MCDONOUGH
State : GA
Zip : 30253-2110
Country : US
Telephone Number : 678-683-1901
Fax Number :
Provider Business Practice Location Address
First Line : 176 ATLANTA ST
Second Line : SUITE B
City : MCDONOUGH
State : GA
Zip : 30253-2110
Country : US
Telephone Number : 678-683-1901
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2016
Last Update Date : 07/21/2016

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Directions to “ REBECCA WARD ” Practice Location

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